Alesci R Sonja, Krekeler Stefanie, Seifried Erhard, Miesbach Wolfgang
Goethe University Hospital, Haemophilia Centre, Frankfurt, Germany.
Blood Coagul Fibrinolysis. 2012 Jun;23(4):320-3. doi: 10.1097/MBC.0b013e328352cafc.
Arterial hypertension is very common and occurs often in patients with haemophilia A (HA) and von Willebrand disease (VWD) due to their increased life expectancy. Bleeding complications in haemophilia and von Willebrand patients with hypertension so far are not well evaluated. Even data regarding the use of antihypertensive treatment in these patients are lacking. That is why we want to establish a register of the patients regarding the bleeding complications under arterial hypertension. The prevalence of arterial hypertension in our patients' population (n = 258 of >18 years, 121 men, 137 women) was as follow: 190 patients had VWD 1, eight VWD 2A, one VWD 2B, five VWD 3, 39 haemophilia A (two severe, one moderate, 36 mild). All patients (n = 258) had arterial hypertension because this was our issue. Certainly, patients even had more coronary risk factors. One important risk factor was hyperlipoproteinemia (n = 111). Nicotine abuse was rare (nine patients, 3.4%). Adipositas (78 ± 18 kg, range 37-164 kg, median BMI = 23.2 kg/m(2)) as well as obstructive sleep apnoea (two patients) were not common. Regarding the cohort, 57 patients with bleeding disorder and hypertension suffered from coronary artery disease. No major bleeding or ischemic complications were observed. Obviously, patients with haemophilia and VWD with arterial hypertension do not have an increased risk of bleeding. Adequate treatment is necessary. International registers with a larger number of patients can be useful.
动脉高血压非常常见,由于血友病A(HA)和血管性血友病(VWD)患者的预期寿命延长,这种情况在他们中经常出现。目前,血友病和血管性血友病合并高血压患者的出血并发症尚未得到充分评估。甚至缺乏这些患者使用抗高血压治疗的数据。这就是为什么我们想建立一个关于动脉高血压患者出血并发症的登记册。我们患者群体(n = 258名年龄大于18岁,121名男性,137名女性)中动脉高血压的患病率如下:190名患者患有1型血管性血友病,8名患有2A型血管性血友病,1名患有2B型血管性血友病,5名患有3型血管性血友病,39名患有血友病A(2名重度,1名中度,36名轻度)。所有患者(n = 258)都患有动脉高血压,因为这是我们研究的重点。当然,患者甚至还有更多的冠状动脉危险因素。一个重要的危险因素是高脂蛋白血症(n = 111)。吸烟情况很少见(9名患者,3.4%)。肥胖(78 ± 18 kg,范围37 - 164 kg,中位BMI = 23.2 kg/m²)以及阻塞性睡眠呼吸暂停(2名患者)并不常见。在该队列中,57名患有出血性疾病和高血压的患者患有冠状动脉疾病。未观察到重大出血或缺血性并发症。显然,患有血友病和血管性血友病且合并动脉高血压的患者出血风险并未增加。进行充分治疗是必要的。纳入更多患者的国际登记册可能会有所帮助。